Non-Cochrane · aetiology · PM41469640
Optimal tooth brushing initiation age and frequency for preventing early childhood caries: a systematic review and meta-analysis.
Al-Sharani Hesham Mohammed, Stormon Nicole, Al-Hutbany Nassr, et al. · BMC oral health · 2025 · PubMed · doi:10.1186/s12903-025-07179-5
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
4
current version
GRADE rated
0
No studies
0
Included studies
29
linked below
No studies 0 · 0%Ungraded 4 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Healthy children aged 6 months to 6 years with no craniofacial anomalies, immunocompromising conditions, or syndromes affecting dental development | 34,050 preschool children (<6 years) from 32 studies across Asia, Europe, North America, South America, Africa, and Australia (n=32) |
| Intervention | Tooth brushing practices: initiation age (before vs after 12 months) and brushing frequency (>=2 vs <2 times/day) | Tooth brushing initiation age and frequency as reported per study; thresholds varied (early from <6 months to <2 years; high frequency >=2/day or >=3/day) |
| Comparison | Early vs late initiation (age-based studies); high vs low frequency (frequency-based studies) | Late (>=12 months or >=2 years) vs early (<12 months or <2 years) initiation; low (<2/day) vs high (>=2/day) frequency |
| Outcomes | Incidence, prevalence, or severity of ECC (>=1 decayed/missing/filled primary tooth; dmft/dmfs index) | ECC presence/prevalence/severity by dmft/dmfs (n=32) |
| Study designs | Observational studies (cross-sectional, longitudinal, cohort) in children under 6; English-language; published 2000 to 2024 | 27 cross-sectional and 5 prospective/longitudinal studies (n=32) |
| Timing | Not specified | Mostly cross-sectional; longitudinal studies followed children to about age 5 (n=5 longitudinal) |
Search date: January 2000 to August 2024. Databases: ProQuest; Web of Science; Scopus
Questions and results
Late tooth brushing initiation (>=12 months, or >=2 years in some studies) vs Early tooth brushing initiation (<12 months, or <2 years)
Population: Healthy children under 6 years of age (6 months to 6 years); preschool children
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Early childhood caries (presence/prevalence/severity by dmft/dmfs) Primary analysis (all 10 studies) In the primary pooled analysis, late tooth brushing initiation was associated with a non-significant 40% higher odds of early childhood caries (OR 1.40, 95% CI 0.91 to 2.16), with very high heterogeneity (I2=90.5%); ungraded. Source: Results, 'Early vs. Late brushing initiation'; Table 3; Abstract · same question in other reviews | OR 1.40 [0.91, 2.16] | 10 studies · 23200 participants | Ungraded |
Early childhood caries (presence/prevalence/severity by dmft/dmfs) Leave-one-out sensitivity analysis (Wagner 2017 outlier excluded, k=9) After excluding one outlier study (Wagner 2017), late brushing initiation was significantly associated with higher ECC odds (OR 1.75, 95% CI 1.50 to 2.03; I2=20.7%); ungraded. Source: Results, 'Early vs. Late brushing initiation' (leave-one-out); Table 3 (sensitivity row); Abstract · same question in other reviews | OR 1.75 [1.50, 2.03] | 9 studies | Ungraded |
Low tooth brushing frequency (<2 times/day) vs High tooth brushing frequency (>=2 times/day)
Population: Healthy children under 6 years of age (6 months to 6 years); preschool children
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Early childhood caries (presence/prevalence/severity by dmft/dmfs) Leave-one-out sensitivity analysis (Alhabdan 2018 outlier excluded, k=7) After excluding an extreme outlier (Alhabdan 2018), the association between low brushing frequency and ECC remained statistically significant (pooled OR approximately 2.0, p=0.003; I2=87.5%); the exact estimate and its CI were not reported; ungraded. Source: Results, 'High vs. Low brushing frequency' (leave-one-out) · same question in other reviews | OR ~2.0 | 7 studies | Ungraded |
Early childhood caries (presence/prevalence/severity by dmft/dmfs) Primary analysis (all 8 studies) Brushing less than twice daily was associated with about 2.1-fold higher odds of early childhood caries (OR 2.11, 95% CI 1.25 to 3.55), with very high heterogeneity (I2=93.36%); ungraded. Source: Results, 'High vs. Low brushing frequency'; Table 4; Abstract · same question in other reviews | OR 2.11 [1.25, 3.55] | 8 studies · 14981 participants | Ungraded |
Included primary studies 29
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Prakash 2012 matched by author and year (probable) | 2 other reviews | not stated | not extracted yet | not extracted yet |
| Alhabdan 2018 matched by author and year (probable) | 1 other review | Early childhood caries (presence/prevalence/severity by dmft/dmfs) | not extracted yet | not extracted yet |
| Elidrissi 2016 matched by author and year (probable) | 1 other review | not stated | not extracted yet | not extracted yet |
| Pereira 2021 matched by author and year (probable) | 1 other review | not stated | not extracted yet | not extracted yet |
| Aida 2008 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Al-Haj Ali 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Buckeridge 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Bulut 2023 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Carino 2003 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Cariño 2003 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Chouchene 2022 matched by author and year (probable) | this review only | Early childhood caries (presence/prevalence/severity by dmft/dmfs) | not extracted yet | not extracted yet |
| Dini 2000 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Hallett 2006 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Jain 2015 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Kraljevic 2017 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Ogunlade 2024 The mathematical formulation of the problem of conduction of impulses in a network of connected excitable elements, specifically in… PMID:20245817 | this review only | not stated | not extracted yet | not extracted yet |
| Ozen 2016 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Peres 2005 matched by author and year (probable) | this review only | Early childhood caries (presence/prevalence/severity by dmft/dmfs) | not extracted yet | not extracted yet |
| Retnakumari 2012 Structural fold, conservation and Fe(II) binding of the intracellular domain of prokaryote FeoB. PMID:20123128 | this review only | not stated | not extracted yet | not extracted yet |
| Selen 2024 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Skeie 2006 matched by author and year (probable) | this review only | Early childhood caries (presence/prevalence/severity by dmft/dmfs) | not extracted yet | not extracted yet |
| Subramaniam 2012 matched by author and year (probable) | this review only | Early childhood caries (presence/prevalence/severity by dmft/dmfs) | not extracted yet | not extracted yet |
| Sun HB 2017 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Sun X 2017 matched by author and year (probable) | this review only | Early childhood caries (presence/prevalence/severity by dmft/dmfs) | not extracted yet | not extracted yet |
| Wagner 2014 matched by author and year (probable) | this review only | Early childhood caries (presence/prevalence/severity by dmft/dmfs) | not extracted yet | not extracted yet |
| Wagner 2017 matched by author and year (probable) | this review only | Early childhood caries (presence/prevalence/severity by dmft/dmfs) | not extracted yet | not extracted yet |
| Wigen 2018 matched by author and year (probable) | this review only | Early childhood caries (presence/prevalence/severity by dmft/dmfs) | not extracted yet | not extracted yet |
| Wyne 2003 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Zhang 2019 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).